<!doctype html>
<html>
<head>
<meta charset="utf-8">
<meta name="viewport" content="width=device-width, initial-scale=1">
<meta name="viewport" content="width=device-width, initial-scale=1, maximum-scale=1, user-scalable=no">
<script src="../static/js/jquery.min.js" type="text/javascript"></script>
<script src="../static/js/bootstrap.min.js"  type="text/javascript"></script>
<link href="../static/css/bootstrap.min.css"  type="text/css" rel="stylesheet">
<link href="../static/css/index.css" type="text/css" rel="stylesheet">
<title>登记</title>
</head>

<body>
<!--头部-->
<nav class="navbar navbar-default navbar-fixed-top  top" role="navigation">
  <div class="container-fluid">
  
        <div class="navbar-header" style=" width:100%;">
                  <a class="navbar-brand"  href="javascript:history.go(-1);" style=" width:100%;  padding-right:0px;">
                  
                   <span class="glyphicon glyphicon-arrow-left white"></span>
               <!--    <span class="glyphicon glyphicon-pause white" style="margin-left:2%;"></span>-->
                   <span class="white" style="margin-left:10%">登记</span>
                   <span class="glyphicon glyphicon-user white" style="float:right"></span>
                 
                 
                  </a>
          
        
        </div>

   
  
  </div><!-- /.container-fluid -->
</nav>
<!--头部 end-->
<!--主体部分-->
<div class="container" style="margin-top:70px;">
    <!-- <div class="row" style="margin-right:10%;">
      <div  class="col-xs-sm  text-right" > <a class="btn btn-primary" href="registration_add.html" style="width:30%">增加</a></div>
     </div>--><!--row  end-->





 <div class="row" style="margin-top:10px;">
       
          
                  <form action="" method="post">
      <div class="col-sm-12 distance" >
        <div class="form-group">
          <label for="inputEmail3" class="col-sm-2 control-label">年级:</label>
          <div class="col-sm-10">
            <select class="form-control">
              <option>1</option>
              <option>2</option>
              <option>3</option>
              <option>4</option>
              <option>5</option>
            </select>
          </div>
        </div>
      </div>
      
      <div class="col-sm-12 distance hierarchy" >
        <div class="form-group">
          <label for="inputEmail3" class="col-sm-2 control-label">日期:</label>
          <div class="col-sm-10">
            <input type="text" id="datepicker" class="form-control "  >
          </div>
        </div>
      </div>
     
      <div class="col-xs-12  distance hierarchy2">
        <div class="form-group text-center" style="padding-top:0px;">
          <button type="button" class="btn btn-success" style="width:80%">搜索</button>
        </div>
      </div>
        </form>       
               
               
      </div>     
     
 <div class="row" style="margin-top:15px;margin-left:1px; margin-right:1px;">
          <h4 class="text-center">xx学校一年级学会僧因病缺课情况登记表</h4>
         <table class="table table-striped table-bordered text-center"  id="middles">
             <caption>2016年10月11日</caption>
             <tr>
                <td>班级:</td>
                <td>101</td>
             
             </tr>
             <tr>
                <td>因病缺勤人姓名:</td>
                <td>张三</td>
             
             </tr>
             
             
              <tr>
                <td>性别:</td>
                <td>
                   <table class="table table-striped table-bordered text-center" >
                      <tr>
                         <td>男</td><td>是</td>
                      </tr>
                       <tr>
                         <td>女</td><td>是</td>
                      </tr>
                   
                   </table>
                 
                </td>
             
             </tr>
               <tr>
                <td>缺课天数:</td>
                <td>3</td>
             
             </tr>
             
             
             
             <tr>
                 <td>因病缺课主要症状</td>
                  <td>
                  
                     <table  class="table table-striped table-bordered text-center" >
                         <tr><td>发热</td><td>是</td></tr>
                         <tr><td>腹泻</td><td>否</td></tr>
                         <tr><td>结膜红肿</td><td>否</td></tr>
                         <tr><td>皮疹</td><td>否</td></tr>
                         <tr><td>黄疸</td><td>否</td></tr>
                         <tr><td>受伤</td><td>否</td></tr>
                         <tr><td>其他（请注明）</td><td>否</td></tr>
                     
                     </table>
                   
                  </td>
             </tr>
              
            
            <tr>
            
               <td>是否就诊</td>
               <td>
                 是
               </td>
            </tr>
            
             <tr>
            
               <td>疾病名称</td>
               <td>
                二
               </td>
            </tr>
             
             
         </table>
      </div>
      
     
</div><!--container  end-->
<!--主体部分  end-->
<!--底部-->

<div class="container" style="margin-top:15%;">
    <div class="row">
       
     <div class="footer navbar-fixed-bottom">
      <div class="col-xs-12" style=" height:15%"></div>
        <div class="col-md-4  col-xs-4 text-center" >
          <p class="glyphicon glyphicon-home white footer_font"></p>
          <p><a href="" class="white  footer_font2">首页</a></p>
        </div>
        
         <div class="col-md-4 col-xs-4 text-center white  ">
           <p class="glyphicon glyphicon-comment white  footer_font"></p>
           <p><a href=""  class="white  footer_font2">消息</a></p>
         </div>
          <div class="col-md-4 col-xs-4 text-center white" >
           <p class="glyphicon glyphicon-asterisk white footer_font"></p>
           <p ><a href=""  class="white  footer_font2">设置</a></p>
          </div>
        
     </div><!--footer  end-->
    
    </div><!--row  end-->

</div><!--container  end-->


<!--底部end-->


</body>
</html>
